Dental Research Journal
Volume:20 Issue: 6, Jun 2023

Successful management of pain during endodontic treatment is essential for both patients and dentists. Achieving adequate pulp anesthesia in mandibular molars is a significant concern for patients with irreversible pulpitis during endodontic treatment. The increased sensitization of nociceptors due to inflammation decreases the success of inferior alveolar nerve block (IANB). The main focus is on reducing inflammation before delivery of local anesthesia to increase the success of anesthetic drugs. This umbrella review aimed to revise, qualify and summarize the existing body of evidence on the effect of premedication on IANB in patients with irreversible pulpitis. A literature search was conducted using electronic databases (PubMed, Scopus, the Web of Science, and the Cochrane Library) with no date restriction until September 2021 to identify the relevant studies. All the cross‑references of the selected studies and grey literature were also screened. Four systematic reviews assessing the effect of premedication on the success of IANB were selected. A conclusion was drawn that premedication with >400 mg of ibuprofen can positively affect the success of IANB.

Visual and advanced instrumental methods are the most common tools for shade selection. The instrumental methods are considered reliable and provide quantifiable values, but the high cost puts them out of the reach of most dentists. Light‑correcting devices provide an economical alternative for clinical shade selection. The aim of this study was to assess the reliability of the light‑correcting device in clinical shade selection.

The in vivo experimental prospective study sample included 60 volunteers aged 18–25 years, with no severe enamel pigmentation or anomaly in anterior maxillary teeth. Two observers performed visual shade matching of the maxillary right central incisor without a light‑correcting device and later with a light‑correcting device at the same time of the day at an interval of 1 week. The shades were confirmed with the control value obtained by using a spectrophotometer. Each observer was blinded to the shade color selected by the other examiner. The data collected were subjected to the statistical analysis. The shade measured with the light‑correcting device and without its use was compared with the control shade obtained by the spectrophotometer. The value closer to the control shade value was considered accurate, and the method used for shade matching would be considered reliable. The Fleiss kappa statistical test was used to assess the reliability of each method. P ≤ 0.05 was considered statistically significant.

Using a light‑correcting device significantly increased the reliability of the visual shade selection method. When compared to the shades recorded by the spectrophotometer (control), the use of a light‑correcting device as an aid in visual shade selection showed more accurate and reliable results as compared to the visual shade selection without a light‑correcting device (P < 0.05).

Light‑correcting devices can assist in reliable shade selection and allow better communication with the dental laboratory technician to provide predictable esthetic results.

Electrochemical disinfection of the root canal system (RCS) is introduced as an alternative to conventional irrigation. The aim of this study was to assess the efficacy of depotphoresis method in the disinfection of accessible and inaccessible RCSs.

In this comparative in vitro study disinfection of Enterococcus faecalis‑infected RCS using two methods,(1) depotphoresis and (2) sodium hypochlorite (NaOCl) irrigation plus passive ultrasonic agitation (PUA) took place on 40 extracted maxillary anterior teeth. Decoronation was done with a diamond disc, and the canals were instrumented. The roots were divided into two phases: the specimens with canal obstruction and the specimens without canal obstruction. The smear layer was removed, and the specimens were infected for 21 days with E. faecalis. After disinfection procedures, bacterial samples were taken using two sterile #35 paper points, and colony‑forming units (CFU) were counted. Data were analyzed statistically using the Kruskal–Wallis test, with a significance level at P < 0.05, to indicate differences between depotphoresis and NaOCl plus PUA groups.

In both phases, Log CFU after depotphoresis treatment was significantly lower than NaOCl irrigation plus PUA treatment (P < 0.05).

Treatment with depotphoresis was significantly more effective than NaOCl irrigation plus PUA treatment.

Dentists are at an increased risk of encountering cross‑infections because of working in close proximity with oral mucosa and saliva making use of high‑speed rotary instruments during treatment generating large amount of aerosols and splatter which in turn increases the probability of nosocomial spread of infections. The present study aimed to evaluate the knowledge, attitudes, and practices of dentists after the COVID‑19 pandemic.

The present cross‑sectional study was conducted using Google Forms wherein a well‑structured questionnaire composed of a total of 25 closed‑ended questions was distributed among practicing dentists through online mode. Step‑wise linear regression analysis was done to determine the influence of independent variables on the knowledge, attitude, and practice scores of the participants. P < 0.05 was considered statistically significant.

On analyzing the results, multiple linear regression analysis revealed no significant difference in the knowledge scores among the participants, while good attitude and practice scores were significantly associated with higher qualification of the participants. Another noteworthy finding in the study was the significant correlation observed between the various components of the knowledge, attitude, and practice scores among the participants (P < 0.05).

It could be concluded from the findings of the present survey that dentists were found to have good knowledge scores about the COVID‑19 pandemic. They should, however, pay more emphasis on practicing tele‑triaging and proper screening and should follow various guidelines and advisories issued from time to time by the competent authorities.

Despite the improvements in optical properties of composite resins, their color stability is still a matter of concern. This study aimed to assess the curing time and intensity and polishing technique on color stability of bleach‑shade composite resins.

In this in vitro, experimental study, 128 discs (1 mm × 8 mm) were fabricated from two composite resins. The specimens fabricated from each composite were assigned to 8 subgroups (n = 8) based on the curing time and intensity and polishing with polishing points or discs. After polishing, the color parameters of specimens were measured by EasyShade spectrophotometer according to the CIEL* a*b* color system. The specimens were then immersed in tea solution, and their color parameters were measured again. Color change (∆E) was calculated and analyzed at 0.05 level of significance. SPSS 25 was used for data analysis. Univariate four‑way ANOVA was applied to assess the effects of composite type, curing time, curing intensity, and technique of polishing on ∆E of composite resins. Since the interaction effects were significant, subgroup analysis was performed by t‑test. The level of significance for this test was set at 0.05.

The effects of curing intensity and polishing technique were significant on ∆E (P < 0.05). Filtek Z350 XBW composite specimens polished by polishing points experienced lower color change than those polished with discs. The minimum ∆E of Gradia XBW composite was recorded in specimens that underwent high‑intensity curing for 20 s and were polished with polishing points while the maximum ∆E was recorded in specimens that underwent high‑intensity curing for 20 s and were polished with discs.

In all groups except on (Filtek, polishing with Disk, curing time = 20 s), high‑intensity curing and polishing with polishing points were more effective and caused lower color change compared with low‑intensity curing and polishing with discs.

This study compared the diagnostic efficacy of VistaCam iX infrared camera, visual inspection, and bitewing‑radiographs for the detection of primary occlusal caries of permanent teeth.

In this in vitro experimental study, 80 extracted human premolars were evaluated. The occlusal surfaces of these teeth were demineralized by immersion in a demineralizing agent. Then, the International Caries Detection and Assessment System (ICDAS II), bitewing‑radiography, and Proxi head of VistaCam iX were used to inspect them. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic modality. Data were analyzed using SPSS. Twenty‑five at P < 0.05 level of significance with one‑way analysis of variance and Games–Howell test.

Bitewing‑radiography had significantly lower sensitivity than ICDAS II and VistaCam (P < 0.05). ICDAS II was comparable to VistaCam, with no significant difference in sensitivity (P > 0.05). ICDAS II had a significantly higher PPV than bitewing‑radiography and VistaCam (P < 0.05). The sensitivity of bitewing radiography was significantly lower than that of ICDAS II and VistaCam (P < 0.05). ICDAS II was comparable to that of VistaCam with no significant differences in sensitivity (P > 0.05). ICDAS II had a considerably higher PPV than bitewing‑radiography and VistaCam (P < 0.05). The NPV of ICDAS II visual inspection was significantly higher than that of bitewing‑radiography and VistaCam (P < 0.05). The ICDASS II and VistaCam had a repeatability coefficient of 47.4%. For bitewing‑radiography and VistaCam, this value was 44.2% and 83.4% for ICDAS II and bitewing‑radiography.

Visual inspection seems to be superior to bitewing‑radiography and VistaCam in detecting primary occlusal caries of permanent teeth.

Plant compounds such as Aloe vera, green tea, and chamomile have been increasingly used in recent years to achieve oral health. This study aimed to determine the antimicrobial effect of chamomile (Matrika), A. vera‑green tea, and chlorhexidine (CHX) mouthwashes on some oral bacterial species.

This prospective experimental study investigated the antimicrobial properties of three mouthwashes, including chamomile (Matrika), A. vera ‑green tea, and CHX as well as distilled water as control on five bacterial species, including Streptococcus Oralis, Streptococcus sanguis, and Streptococcus mutans as primary colonizers and Porphyromonas gingivalis and Eikenella corrodens as secondary colonizers. Colony‑forming unit was used to count the colonies and disc diffusion and well diffusion methods were used to measure the diameter of zone of inhibition. Data were analyzed by SPSS (version 22) software using descriptive statistics, ANOVA, Tukey, Kruskal–Wallis, and Mann–Whitney tests (α = 0.05).

CHX had a significantly higher antibacterial effect than the other two mouthwashes in all three methods (P < 0.001). Further, the herbal mouthwashes in all three methods had a statistically significant effect on the bacterial species (P < 0.001). A.vera‑green tea mouthwash had a significantly higher effect than chamomile mouthwash (Matrika) on all bacterial species except for S. sanguis (P < 0.05).

The findings showed that herbal mouthwashes had potentially antibacterial effects, but these effects were significantly lower than that of CHX. However, more clinical studies are needed to prove the current findings.

This study investigated the number of bacterial colonies in four types of suture threads, including silk, nylon, monocryl, and monocryl plus after periodontal surgery in patients with moderate‑to‑severe periodontitis.

In this single‑blind randomized clinical trial, a total of 12 patients with periodontitis who required periodontal flap surgery in all quadrants were included. One type of suture, either silk, nylon, monocryl, or monocryl plus (coated with triclosan), was used following each surgery in each quadrant. Sutures (3 mm) were removed from the mid, posterior, and anterior regions of the flap 7 days postoperatively, and placed in a tube‑containing buffer medium to transfer to the culture medium in a laboratory. Then, the bacterial colonies on each culture medium were counted manually. Finally, the mean number of grown colonies(anaerobic and aerobic) was computed and compared in each group of sutures. Data were analyzed by SPSS (Version 20) using the repeated measures ANOVA and least significant difference follow‑up tests (α = 0.05).

The findings of this study indicated a significantly higher mean number of aerobic, anaerobic, and aerobic‑anaerobic colonies in silk suture than in the other three types of sutures (P < 0.05). However, no significant difference was observed among other types of sutures (P > 0.05).

The results of this study showed that silk suture had a higher bacterial adhesion (aerobic, anaerobic, and aerobic‑anaerobic) than monofilament sutures, including nylon, monocryl, and monocryl plus. Moreover, no significant difference was found among the monofilament sutures in the number of colonies grown on them.

Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation for diabetes screening with a minimum paraphilia and for all medical settings.

We have thus conducted a systematic review and meta‑analysis according to Preferred Reporting Items for Systematic Reviews and Meta‑Analysis guidelines, to quantify the association between diabetes and effectiveness of periodic acid–Schiff staining of exfoliative cytology as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case– control cross‑sectional) were selected and evaluated in depth. The statistical evaluation was done with a forest plot with odds ratio and weightage examined.

It was proved that exfoliative cytology with periodic acid–Schiff (PAS) staining can be used as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive test is a conclusive screening practice for diabetics.

This systematic review and meta‑analysis suggest that PAS staining in exfoliative cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to further evaluate the plausibility of the results.

The literature on the effect of bleaching on stainability and color stability of any composites is scarce and controversial. In the case of some composites and/or bleaching agents or staining solutions, there is no previous study. Therefore, this rather large study was conducted for the first time to examine simultaneously the effects of bleaching and 3 staining solutions on 3 composite types.

This 3‑phase experimental in vitro study was performed on 18 groups of 5 specimens each: 90 composite discs with 10 mm diameter and 1 mm thickness were fabricated from 3 resin composites (microhybrid, nanohybrid, and nanofilled). Forty‑five discs underwent bleaching with 15% carbamide peroxide, and the remaining 45 were immersed in distilled water at room temperature. The color assessment was performed before and after this step, and ∆a, ∆b, and ∆L color parameters were calculated for each specimen. The specimens were then immersed in coffee, cola, and red grape juice for 2 weeks, and underwent colorimetry again. The simultaneous effects of bleaching and staining agents and composite types on ΔE (color changes) of composite specimens were analyzed using an independent‑samples t‑test, a Mann–Whitney U‑test, and two‑way and one‑way analysis of variances followed by a Tukey and a Dunnett’s T3 tests ( = 0.05).

Bleaching had no significant effect on color changes of microhybrid, nanohybrid, or nanofilled composites (P > 0.05). The stainability of composites did not increase after bleaching (P > 0.05). Regardless of the composite type and the presence of bleaching, coffee had the worst effect on color of composite specimens, while cola had the smallest staining effect (P < 0.05).

Stainability of microhybrid/nanohybrid/nanofilled composites did not increase after bleaching with 15% carbamide peroxide. Coffee should be consumed with care, as far as composite coloring is a concern, regardless of the type of composite in use or its bleaching history. Cola was the weakest stainer. Coffee always caused perceptible staining (ΔE >3.7), regardless of the composite in use or its bleaching history. Red grape juice caused such perceptible colorations in most cases. Cola did not cause any perceptible discoloration in most cases.

Impression making in compromised residual alveolar ridge is a regular challenge in rehabilitating patients with conventional removable complete dentures. In patients who cannot afford implant‑supported dentures, specialized impression technique is a viable and justified option for fabrication of complete dentures. More often, the stability of denture in such patients becomes a deciding factor between failure and success. Furthermore, increased interarch space may result in increased height of maxillary and/or mandibular dentures with corresponding increase in weight, which further compromises the retention and stability of the prosthesis. This article describes an amalgamation of Hobkirk’s impression technique in a case of resorbed maxillary residual alveolar ridge with a flabby anterior segment and fabrication of hollow maxillary dentures using a “three‑dimensional printed dental spacer” with a “double‑flask technique.” The weight of the final prosthesis was reduced therefore contributing to improved retention and stability of the final prosthesis.